title: Biomechanical analysis of endobutton versus screw fixation after Lisfranc ligament complex sectioning.
abstract: BACKGROUND
  Our goal was to compare diastasis after endobutton and screw fixation after Lisfranc ligament complex sectioning.
  
  
  METHODS
  Twenty-four (12 pairs) fresh-frozen cadaveric feet were assigned to endobutton or screw fixation and loaded to 343N. Displacement (first-second metatarsal bases) was measured in intact feet and after ligament sectioning (Lisfranc, medial-intermediate cuneiform ligaments), fixation, and 10,000 cycles.
  
  
  RESULTS
  The mean change in diastasis for endobutton and screw fixation under initial loading was 1.0mm (95% CI, 0.2-1.9mm) and 0.0mm (95% CI, -0.4 to 0.4mm), respectively (p=0.017). After cyclic loading, diastasis decreased (mean, -0.7mm, 95% CI, -1.2 to -0.1mm) in the endobutton group but was unchanged in the screw group (p=0.035).
  
  
  CONCLUSIONS
  Diastasis after endobutton fixation was significantly greater than after screw fixation under initial loading but did not increase further after cyclic loading.
authors.affiliation: International Center for Orthopaedic Advancement, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Marsland
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Belkoff
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Solan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D001863:Bone Screws; D002102:Cadaver; D005260:Female; D033023:Foot Joints / Q000502:physiology / Q000601:surgery; D006801:Humans; D008023:Ligaments, Articular / Q000293:injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009984:Orthopedic Fixation Devices; D016474:Weight-Bearing
keywords: Biomechanical; Endobutton; Lisfranc ligament rupture; Screw